Tuesday, April 2, 2013

Things That Piss Me Off Tuesday - the I'm beyond pissed off edition

It's a good thing I waited a few days to write about this.  Honest.

Had I done it last week, this post would have been filled with horrendous language, probably every other word.  The kind of words that make sailors blush.  Those ones.

It was a bad week.

The Entire Healthcare Industry - yep all of it
I spent every.single.day. last week fighting with insurance companies, dealing with pharmacies and the employees who surely got tired of seeing my angry face, and making phone call after phone call after phone call to the doctor only to pick up yet another script that I took back to the pharmacy and found out we still couldn't afford.

My daughter needs medication to treat a recently diagnosed condition.  Because of the way that our wonderful health care system works, doctors have no idea how much medication costs.  They prescribe what they prefer, which usually is whatever the reps from big pharma push at them the hardest.  (don't even get me started on that, it's another post entirely)  Our doctor's office has a handy little icon system that's supposed to approximate affordability when they pull up possible medications in their computer....except that it's no more accurate than just pulling a number out of thin air.

The pharmacy can't look up substitutes without having a written prescription, since everything has to actually be run through the insurance to see how much it will be.  The insurance company has a formulary online, but it's wrong.  The employees of the insurance company that I talked to gave me even more wrong information.

NO ONE INVOLVED IN TREATMENT HAS ACCESS TO COST INFORMATION.  The doctors don't know, the pharmacists can't tell. Hell, even the insurance company doesn't actually know.  Patients (and their parents) are at the mercy of a system that operates with no transparency, forced to try and figure it all out backwards. This is what is wrong with health care, my friends.

By Friday, I was ready to tear my hair out.

Four days had passed.
Four prescriptions.
Four trips to the pharmacy.
Four times I came home with nothing.
Four days of telling my kid that I was doing the best I could to get what she needed.

I can't afford a medication that is going to cost $200/mo.  On the fifth day, we finally got a prescription that we could swing the cost of.

We have insurance.  My husband works in the industry.  We still can't afford the cost of health care.

When it comes down to it, the only difference between the medication we ended up with and most of the other ones we tried (all generics by the way)....ready for this????  A coating.  A teeny tiny little film around a capsule.  That's it.  That's the difference between $36/mo and $200/mo.

When I finally dropped off the last prescription, the pharmacists as frustrated as I was, they all understood.  We already have to pay 100% out of pocket for diabetes test strips and all the other testing supplies.  The last batch set us back over $500.  Sure, it counts towards our deductible....but we still have to pay 100% for strips even after we meet it.  The strips aren't covered.  At all.  Insurance will cover insulin if and when we get to that point, but they'll never ever cover the strips - the things that actually give us the most immediate information about my son's health.

I'm extremely grateful that my other daughter seems to finally be outgrowing her asthma.  One of her inhalers is $800/mo. I'm not kidding. She ran out of that medication and we couldn't afford to refill it, so she's making due with what we have. Thankfully it seems to be enough.  Trying to keep three kids with chronic conditions healthy is killing us financially.

I had all kinds of other things to be pissed off about, like GMOs and bees and vaccines...but I'm still too wrapped up in all this to devote the proper amount of energy to them.  Maybe next week, although by then I'll have a whole new list.


  1. Oh, Honey! I am right there with you.we pay thousands of dollars a year to HAVE the insurance so that we can pay another thousands of dollars before insurance kicks in and picks up a percentage of the cost.Pharmaceutical companies are out of control. The Doctors are beyond knowing.It is so frustrating and infuriating,espeecially when your child is ill and needs something you just cannot provide instantly.

  2. I've never understood why insurance won't cover test strips. I dated a guy who's mother actually would only check her blood sugar once a week due to the cost of test strips. I probably don't have to tell you how that turned out for her.

  3. This is infuriating. You are such a good mama for fighting for your kids as hard as you do, but I know it must be wearing on you terribly. Is there an assistance program in your area that could possibly help you with some of your medication costs? A couple of the Catholic charities here in Kentucky provide free or extremely discounted medical supplies and prescriptions, even for families that are well beyond the traditional financial brackets for federal or state assistance programs. Our neighbor is diabetic, and he gets free strips from them. Perhaps there's something similar in your area?

  4. We don't have insurance, I refuse to pay 10's of 1000's not to get sick but when we need drugs we use Canada drugs. My husband's medication for his high triclycerides are $400 p/m here but we can get them from Canada in a week for 50... A little planning can go a long way.
    That an insurance company is in charge of who can receive what in health care is disgusting. It makes it worse for us coming from a free healthcare system. Try www.canadadrugs.com. It works for us.

  5. Really sorry that you're having such a tough time over this! This should not be your primary concern; you should be able to spend that time with taking care of your family!

  6. Kelly, it doesn't solve the problem you have pointed out here... BUT, have you ever contacted the manufacturers direct? SO MANY of them now send you for FREE meds and medical supplies to the under-insured & uninsured.
    There is NO WAY, I could afford my Neurontin ($287/mo for the Generic Gabapentin!) I called Pfizer, the manufacturer of Neurontin, and with a valid Rx they send, to my home AT NO COST, not even any shipping charges, my Rx! I hope some of the big drug companies can help you too.


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